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Topic: Massachusetts & Other Testing Info. (Read 37428 times)

Massachusetts is in the forefront of HIV research. The work done at Massachusetts General Hospital continues to be some of the most important in searching for treatments and strategies to halt the spread of the virus.

Accordingly, Mass. has taken the lead in research on window period research. Call the Massachusetts state HIV/AIDS hotline, which is fully endorsed by the Massachusetts State Department of Health. Their counselors will tell you time and time again, without equivocation, that a six week window period is definitive. In fact, they will state that six weeks is "more than enought time" to produce antibodies.

Massachusetts goes on to state that the CDC's 3 month window is now the "conservative" time frame to cover the "outliers" that have suppressed immune systems due to chemotherapy, lupus, or other similar afflictions. If you have no such problems, you can consider the 6 week test to be defnitive.

Furthermore, the six week window does not depend on "4th generation technology." The Massachusetts officials on the hotline will inform you that Orasure, Oraquick, and all other antibody assays currently in use meet the 6 week window parameters!

Although Dr. Bob on The Body continues to encourage a 3 motnh window, he has stated that he has no reason to doubt the Massachusetts guidelines!

So if Massachusetts can so confidently endorse a 6 week window for EVERYONE except the immuno-compomised (CALL THEM AND VERIFY WHAT I AM SAYING! - 1-800-235-2331)....why can't the experts on this site?

Sorry, forgot to include the other info. I wanted to share:1) For those of you in the LA area that are inside a "window period" - the Los Angeles Gay and Lesbian Center is now offering free NAAT screening to all who test at their main center (on Schrader Blvd. in Hollywood). THis screening is the same test used by the Red Cross in screening the blood supply. The officials at the Gay and Lesbian Center state that it is definitive at 3 to 4 weeks. Visit the website for more infor: www.lagaycenter.com

2) The AIM Healthcare Foundation (two walk in sites in Southern California) offers DNA PCR tests for only $100. They also have a number of draw stations throughout the country that will perform the test for $140. The results are ready in 24 hours!!! This is the only test used in the adult film industry to clear performers for non-condom sex scenes. The outbreak in the industry a few years ago was contained because of this test. The "patient zero" was identified within 30 days of his infection due to the DNA PCR screening. If that patient had waited "3 months" to get an antibody screen, he would have infected coutnless more people!

The officials at AIM perform over 40,000 DNA PCR screens each year! They know what they are talking about!

Regardless of what AIM do or say, PCR testing is NOT approved for diagnostic purposes because they have a high rate of false positive results. We do NOT encourage PCR testing for this reason.

We do tell people here that a six week test is an excellent indicator of their true hiv status and a negative at that time rarely changes. But as Rodney says, until the official window period changes, we will stick to 12-13 weeks for a conclusive result.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Personally, I don't doubt the MA window period for one moment. However, MA is only one small part of the world. Until the majority of official window periods are changed, I'm sticking to the three month one.

Is there a reason why you are so concerned about window period lengths?

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

So if I take an Orasure test in Massachusetts at 7 weeks that comes back negative, I can consider myself negative.

But if the next day I move across the border to Vermont and take the same Orasure test at 7 weeks and 1 day, I'm no longer relaibly negative!!!!!

Doesn't really make sense does it.

Oh, and by the way, call the GMHC hotline in New York City (1-800-243-7692). They are now quoting the New York State Health Department guidelines that state that 98% of people will seroconvert by 4 WEEKS!!! And only the rare exceptions will take longer!

My concern about winodw period lengths rests in my own experience of wasting weeks of my life worrying about seroconversion when I could have and should have accepted the results of a 6 week test!

Not only that, the logic of AIM, Massachusetts, New York, and even North Carolina of all places that providing early, accurate results will help contain the spread of HIV makes sense to me.

So if you retest at 8 weeks and it's a positive test and confirmed by a Western Blot test. How many people would YOU have infected? Knowing you didn't use protection in the first place got you to this point to begin with.

But Rapid that's my point...unless you fall into the category of immunosuppressed, IV drug user, or chemo patient...you WILL NOT test positive at 8 weeks if you tested negative at 6 weeks!!

Could you possibly believe that the officials in Massachusetts would confiently state that 6 weeks is definitive if it truly is possible to test negative at 6 weeks and positive at 8 weeks???

Imagine the legal, moral, medical, etc. ramifications of an officiao state agency making such a mistake. Don't you think that Mass. officials had to be CERTAIN of their guidelines before thay issued them?

Wouldn't you think if ALL states believed in that assessment of 6 weeks they would have all changed their window period? Like I said, IF and WHEN the CDC changes their window period, that will be when we change ours.

First of all, ALL states have not yet changed to the 6 week window because they look to the CDC for their guidelines. Most states look to the CDC for their guidelines becasue they have little or no research going on in their own states regarding HIV transmission.

The states that have the most advanced research and teh cities with the most experience with the epidemic (NYC and San Francisco) ALL quote a 6 week definitive window!

As everyone acknowledges (including Ann who stated above that she does not doubt the Mass. data!), the CDC is the MOST CONSERVATIVE of all agencies working in this area.

Personally, I prefer to go with the MOST ADVANCED AND UP TO DATE inforamtion, rather than the most conservative.

I encourage readers to call the Massachusetts hotline and talk to the counselors yourselves, (1-800-235-2331). Post the results of your conversations here.

More to the point, was her observation current? Tests have changed a great deal in ten years. Also, was it documented? Was she relying solely on patient report of sexual activity? If so, is she a clinical psychologist, trained in interpreting data and patient interview over time?

Seriously.

Logged

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I talked to a doctor who leads the state in HIV testing in Massachussetts about how they came up with 6 weeks as a conclusive test. He said the state conducted a huge study following a very large group of MSM participants. The study concluded that ALL men who seroconverted during this test did so within 6 weeks using modern assays AKA 3rd gen or higher. Also, the public health dept of Mass is funded by the CDC and I assure you if the CDC had proof that what they were saying was incorrect they would say something about it. More importantly, if people were coming back positive after a 6 week neg, we'd hear about it. In the medical field there is acceptions to everything. Nothing is 100%, but for all general purposes it is accurate. I would say thay most of the leading researchers/doctors conclude that 6 weeks is accurate:

"Not only have I never had a case, I have never heard a story from any of my many colleagues (who have much greater experience than I do) having a patient who was HIV negative 6 weeks after exposure and positive later. Unless, of course, there were new exposures in the meantime."

- H. Hunter Handsfield, M.D., Senior Health Research Leader at the Battelle Center for Public Health Research and Evaluation, Seattle, Washington, and Clinical Professor of Medicine at the Center of AIDS and STD, University of Washington.

"The AIDS virus replicates (reproduces itself) very quickly: minutes. But, the tests to detect whether someone has been infected with the virus after exposure take much longer to be accurate. The standared HIV test is positive within 3-4 weeks of exposure (the older HIV antibody tests took 2-3 months). In situations where someone has symptoms of acute HIV infection (high fever, swollen glands, rash) we use a test to look for the virus itself, the HIV viral load test. This test detects HIV within 2-3 weeks of exposure and is used in cases where people have symptoms of ACUTE HIV infection. In your case, assuming you are feeling well, you should get a HIV antibody test four weeks after your potential exposure."

- Dr. Lisa Capaldini, An Associate Clinical Professor of Medicine at University California San Francisco where she has presented lectures with topics including AIDS, the doctor-patient relationship and working with gay and lesbian patients since 1988. She is held in high reguard and is one of the nations leading HIV experts.

"With the new generation of tests, one at 6 weeks is conclusive. I do not know the reasons the CDC is reluctant to accept that, although I suspect they are concerned about missing any truly positives at that point."

With all that being said, the people here at aidsmeds.com can't go on and tell everyone to stop testing at 6 weeks even if it is accurate because they would be underminding the CDC. More people look at this site than just industrialized countries. All they (aidmeds moderators) can state is what they do: the CDC says 12 weeks is accurate and 6 weeks is more than a good indicator. Ann has said on here many times she's never seen a 6 week turn pos later so she does the best she can without contradicting the CDC.

SIDENOTE: I hate the word "conclusive" because it undeminds the word "reliable." NOTHING in this world is conclusive. The test itself isn't even 100 conclusive "BUT" it's accurate.

Couldnt of put it better myself. I was thinking about putting something exactly like that. Done hundreds and hundreds of hours of research on this and almost all HIV doctors/ experts say that 6 weeks is as much a lock as it comes HOWEVER. There are a few exceptions (like 1/10000) and what would happen if sometime down the line someone test positive after the 6-8 week window and then infect his/her loved one?? Then Ann and all the experts would be held accountable and lambasted by the person that was told they were okay. Just my .0000001 opinion.

I would like to throw one thing in here since AIM was brought up and the possibilty of a bunch of folks running to their web site exists. AIM states in the frequently asked questions section of their web site that "HIV can be detected just after about two weeks (give or take a day or two)" with the qualitative DNA PCR test they use. They also reference that they can provide a result 14 days after exposure on the splash page of their web site. I spoke with one of their customer service reps who told me that the test is 95% conclusive after two weeks. I certainly would not want to say they are wrong, but the information they supplied me does not hold much water when I investigated this further. I was told they use the Roche Amplicor version 1.5 of which I was told by several reputable organizations is 99% conclusive after 28 days. And, there is not data on percentages or probibilities prior to 28 days. Under the lesson section of the AidsMeds site, the 28 day timeframe is clearly referenced. Testing prior to 28 days with this test is meaninless unless someone wants to get peace of mind for about 30 minutes at which point the realize they need to test at 28 days or later. That in turn provides relief for a little bit longer until it sets in that an antibody test is still needed.

Now, I must say that it is a good thing that the folks in the porn industry test every 14 days given the frequency of unprotected sex. But it is important to know that the test does not give a conclusive result at 14 days. The HIV scare in the porn industry in early 2004 even proves this out though the population of the group is small. Two of the performers who were infected by the initial patient tested negative at about 13 days and 20 days post-exposure respectively. Those two tested positive on later tests that were conducted past 28 days.

It is important to remember that the FDA has not approved the PCR for diagnostic purposes but the standard antibody test has been. If you look at the numbers - PCR 99% accurate and antibody 99.9% accurate - they look like they are pretty close. But if you have agroup of 1000, that means 10 of them could be positive even though they had a negative PCR and 1 could be positive if they had a negative antibody. That is a big difference if you are one of the 10. And of course, none of them would be positive just due to percentages. There always has to be some error factored in for any test - a little more for the PCR due to the complexity and chance of a false positive.

Sorry to ramble on, but these folks at AIM get under my skin a bit with their claims and I was worried that someone may take the test at 14 days and assume everything is OK after that. I personally believe the PCR test is a good one in the case where a real risk exists and someone wants to go the route of a clinical trial for meds during the acute stage. The worry here though is that a ton of WW's did not have a risk.

The make the claims on the Elisa. I only brought the pcr up because it and AIM were referred to earlier in the thread and I did not want anyone to look at the AIM web site and accept the PCR time line information without more info.

Sorry for hijacking the thread..but just to be curious, generally in the U.S what generation HIV antibody test is used?Say u go for HIV test, and u ask no questions, and they perform the test, then wat generation test is the minimum requirements in the U.S that they use.Stud

Sorry for hijacking the thread..but just to be curious, generally in the U.S what generation HIV antibody test is used?Say u go for HIV test, and u ask no questions, and they perform the test, then wat generation test is the minimum requirements in the U.S that they use.Stud

Doc HHH has mentioned repeatedly that people shouldn't bat an eye on which generation tests are being used when they test.

Doctor HHH, always claims he's not an expert on HIV, that he only gives assessments.

Doc is an expert in the "transmission" of STD's "AND" HIV. However, you are correct that he is not an HIV physision and always directs those who do become positive to places like thebody.com. where people can get better information on living with HIV. He also is the clinical Professor of Medicine at the Center of AIDS and STD, University of Washington.

"This forum is limited to prevention of HIV and to safe sex in general. If you believe you might have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or the risks associated with specific sexual practices, this is the site for you. No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics.

Sorry, your main questions are beyond the scope of my advice, and I pretty much stopped reading your question after paragraph 2. See the prominent disclaimer at the top of the forum, including "No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics." I do not deal with clinical assessment, treatment, or advice for HIV infected persons, only prevention. I'm definitely not an expert on clinical management of HIV/AIDS.Good luck-- HHH, MD

And since when did this thread become a free-for-all frigging discussion? What makes people think that the "no hi-jacking" rule doesn't apply to this thread?

Am I Infected? is a forum where people seek advice about HIV transmission, prevention and testing. It's not a bloody round table gab fest to post links from other HIV sites, discuss the career of Dr HHH or ruminate on the views of the CDC.

If you want to post links or ask questions, do it in your own threads people!

Matty, we understand your fustration but if you can't go to aidmeds.com to discuss hiv issues where do you go? This topic is the probably the most debatable issue when it comes to HIV. When you have states/doctors/organizations with different guidelines it gets confusing for everyone. I can even sense the fustration in moderators on this topic. People should be able to come to a quality site like aidsmeds and see this topic discussed. There really isnt a place for HIV testers to have HIV related discussions other than the am I infected site. I've always said I thought a discussion section for negative people testing might work. Not so much for transmission facts but rather off beat HIV topics such as this. I do see your fustration in this matter, just as I see the fustration of the WW seeking answers to this topic.

Listen, I don't have a problem with people wanting to discuss these issues. There are plenty of places on the internet for people to discuss these issues.

Am I Infected? is not, as I understand it, a discussion forum. It's an advice forum. Ya dig? There are other forums here for discussion and debate of these issues, but they're restricted to HIV positive people and people directly affected by the virus. AIDSMEDS was created with positive people in mind.

If HIV negative people want to have a palaver about these issues, then go and start a google group or something where you can fret about blowjobs, stripper's underwear, saliva and exchange links from the CD frigging C to your heart's content.

I hate to get back on the topic but one thing that I have heard doc HHH say is if someone has had clear and present danger, meaning "confirmed" exposure with someone positive he recomends testing out to 12 weeks. I don't think he doubts the 6 week in this case he like everyone stamps the CYA statement on.

Mods get mad because WW want to make the window shorter and HHH gets mad becasue WW won't accept 6 weeks and move on with their lives. The madness of it all..

Matty, don't leave. We want your input and experience on issues like this.

This thread is going no where fast and and is serving no clear purpose. I think this is the first poster I've seen who is arguing that the six week window is sufficient - we more often see people arguing that six MONTHS isn't even good enough.

Here's the bottom line. A six week negative test is an excellent indication that a person is indeed hiv negative. That should be confirmed at three months as much for the peace of mind of the person being tested as anything - and to catch the rare person who takes slightly longer than six weeks to seroconvert.

Of course, we're talking about people who have had a genuine risk, which is unprotected anal or vaginal intercourse. The majority of people who come through this forum don't even need to test over the specific concern they bring to us.

And as for PCR testing, you will NEVER see me advocate its use in a diagnostic setting. This test should only be used when a positive diagnosis has already been obtained through both a positive ELISA followed by a positive Western Blot. PCR testing is NOT approved for diagnostic purposes, period. And with good reason.

I'm locking this thread. Don't bother starting a new one to hash this stuff out either. It's pointless. The official window period for a genuine hiv risk is three months and that's that.

Use condoms for anal or vaginal intercourse and you won't have to worry about window periods. Just get your annual or semiannual sexual health check ups and be done with it.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts